TNF and acute respiratory distress syndrome: However, Kox et al. described that plasma concentrations of tumor necrosis factor (TNF), IL-6, and IL-8 taken in the first 24 h of ICU admission were lower in patients with acute respiratory distress syndrome (ARDS) in IMV with COVID-19 than in patients with septic shock with or without ARDS and comparable to patients with out-of-hospital cardiac arrest and multiple traumas (9).